AABB (formerly known as the American Association of Blood Banks) recommends a restrictive red blood cell transfusion strategy for stable adults and children, according to new guidelines being published in Annals of Internal Medicine. Physicians should consider transfusing at a hemoglobin threshold of 7 to 8 g/dL, as the evidence shows no difference in mortality, ability to walk independently, or length of hospital stay between patients on a liberal transfusion strategy or a restrictive strategy. Wide variability in the use of transfusions in the United States indicates that in many settings patients are receiving unnecessary transfusions. "Our recommendation is based on the evidence that restrictive transfusion is safe and associated with less blood use, " said Jeffrey L. Carson, MD, Chief of the Division of General Internal Medicine at UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ, and lead author of the guideline.
UCLA stem cell researchers have shown that insulin and nutrition keep blood stem cells from differentiating into mature blood cells in Drosophila, the common fruit fly, a finding that has implications for studying inflammatory response and blood development in response to dietary changes in humans. Keeping blood stem cells, or progenitor cells, from differentiating into blood cells is important as they are needed to create the blood supply for the adult fruit fly. The study found that the blood stem cells are receiving systemic signals from insulin and nutritional factors, in this case essential amino acids, that helped them to maintain their "stemness, " said study senior author Utpal Banerjee, professor and chairman of the molecular, cell and developmental biology department in Life Sciences and a researcher with the Eli and Edythe Broad Center of Regenerative Medicine at UCLA.
Thromboembolic events - such as deep vein thrombosis (DVT), blood clots developing in the extremities; or pulmonary embolism (PE), a complication that causes a blood clot to move to the lungs - can occur following musculoskeletal injury and related surgery, and are potentially life threatening. In "The Incidence of Thromboembolic Events in Surgically Treated Ankle Fracture, " a study appearing in Journal of Bone and Joint Surgery (JBJS), researchers sought to determine the frequency of, and potential risk factors for, thromboembolic events following surgical treatment of an ankle fracture. Investigators reviewed the records of 1, 540 patients who underwent ankle fracture surgery at one of three university hospitals between 1997 and 2005. The incidence of thromboembolic events was 2.
Everyone is familiar with the pain of skinned knees. However, the complex pathway of proteins that works behind the scenes after the bleeding has stopped is not as well known. Central to this process is the production of plasmin, a powerful blood enzyme that disposes of blood clots. Doctors also harness the "clot busting" abilities of plasmin to treat patients who suffer heart attack or stroke. Now, a study published by Cell Press in the journal Cell Reports provides remarkable new insight into how plasmin is produced. This work may lead to more effective clot-busting drugs. Plasmin is released into the blood in an inactive form called plasminogen. Circulating plasminogen is curled up in a "closed, " activation-resistant form. In order for plasminogen to be converted to plasmin, it must first undergo a dramatic change in shape and "open" itself up.
Within all our cells lies two meters of DNA, highly ordered in a structure of less than 10 micro meters in diameter. Special proteins called histones act as small building bricks, organising our DNA in this structure. Preservation of the structure is necessary to maintain correct function of our genes, making histones detrimental for maintaining a healthy and functional body. The research group of Associate Professor Anja Groth from BRIC, University of Copenhagen, has just elucidated a function of the protein Codanin-1, shedding light on the rare anemic disease CDAI where development of the red blood cells is disturbed. The new results also contribute with important knowledge on how our DNA-structure is maintained and how our genes are regulated. "We became interested in Codanin-1 as it was well-known that mutations in the gene cause CDAI, whereas the function of the protein was entirely unknown.